Endovascular repair for retrograde type A aortic dissection with malperfusion.

An 81-year-old man became semiconscious and suffered back pain followed by chest pain. Computed tomography showed retrograde acute type A aortic dissection with entries in the proximal and middle descending aorta, and an occluded true lumen of the right carotid artery. Emergency endovascular repair was performed. Immediately after deploying a stent-graft, aortography showed recanalization of the right carotid artery and no blood flow in the false lumen of the ascending aorta and aortic arch. The postoperative course was uneventful. Computed tomography at 6 months after the procedure showed obliteration of the false lumen and a patent right carotid artery.